How do they get away with charging so much?

[luvdzne]

I still think the point of my post was not to say how the over all fees were outrageous. The point of it was that to put the splint on my daughter (the nurse practitioner did it, no nurse was in the room and it took literal one second to slip it on her arm) is costing $330 and the fact that both the doctor and facility are charging for it. The doctor charged the $135 to diagnose her, so they charged another $155 on top of that to put the splint on. And again, where I think $155 is still high to do so, I am not disputing that particular charge. I am also not disputing that she diagnosed my daughter and should be paid for it. What I am upset about is I don't think that the facility should also be able to charge another $175 for what the dr did. So hence I am being charged twice for it. I agree whole heartily that health care cost a lot of money, but like I said in my previous post that lately I am finding a lot of billing errors that have in fact been confirmed by the insurance co, as well as the insurance co. charging wrong co pays to me.

Also to add that no the doctor did not examine my dd, they put her in a room, took her to do an x ray, the doctor came in said it was not broke and put the splint on. So the doctor spent enough time with dd to say no it's not broken, but we will put a splint on it and put it on. Total time with the doctor, less than 5 minutes.

So I hope that I can straighten any confusion that I am not confused, upset, surprised, or even shocked at the overall charges of the urgent care visit. I am upset about the double charging. The insurance co. is looking into this so I will update the outcome.

 

[TurboKitty]

Right.

They are outrageous. Completely. They also have far too many people in on the scam and obviously need an excuse to pay them.

I was tapped as a bone marrow donor for someone in need. Rather than fly me out and do the medical check in DC, they let it happen here.

Much paperwork and many phone calls went out prior to my appointments, yet I am getting bills. All the bills state "No insurance noted" rather than, "billed party should be" as written/noted.

The first bill was for Urgent Care. I needed to chest x-rays, cost of $35.00.
( Not bad...)

Second bill was lab work, $385.00.
Morons. I had to go back twice. They couldn't follow directions. None of them - either mine, the doctors, the printed ones, or the ones in THE OVERNIGHTED FED EX BOX. Even after the second visit, they insisted I had to drop off the blood samples to the Fed Ex place myself. Yes, I had to drop off the still warm vials of blood because they were clueless.

To say that "they inspired any sort of confidence", is a gross understatement.

Then I got yet another bill. From the doctor. Because I was "A new patient" (my last dr retired), plus the additional test were $285. Riiiiiiiiight.

I did need a vein check, to be sure all was good, and an EKG, but as they did that right there in the office...

Just makes me wonder...How much do they pay these billing people? Can they actually READ? I know I had about six copies of the "please bill us for this for the reason of bone marrow donation, here's three phone numbers to verify this information..." yet I am getting bills.

 

[kejoda]

You are very lucky that your dd did not break her wrist. Our son fell off his bike and ended up breaking his wrist. The doctor told us we have one chance to get it fixed right or he will always have problems with his hand. I don't care what it costs us as long as it gets fixed.

Sometimes you just need to count your blessings.

 

[azgal81]

Wow that is alot of money! I thought insurance covers everything I guess my insurance plan has me jaded our urgent care cost 20 co pay but they refund us 10 dollars if we get admitted. That's it everything else is covered. I only pay 25 bucks a month for medical insurance. I'm so lucky! I'm in shock. You were ripped off.

 

[TurboKitty]

The thing I got was...


They bill insurance companies WAAAAAAAY too much.

They found a way to jusify that.

I am disgusted by all of it.

 

[Caropooh]

That is totally awful...I am so sorry that this had to happen to you and your child.

All I can say is thank God I live in Canada. Last week I had my gall bladder out and I will never see a bill and I don't have Out of Pocket insurance either...my bill is 100% covered by the Goverment Health Care Plan. I can now see how lucky we really are...

Out of curiousity, how long did you have to wait to have the surgery? A friend of mine from Saskatchuen(sp) says that she has had to wait literally MONTHS to have shoulder surgery.

 

[Aidensmom]

Does anyone really read the forms they get from their insurance company on the charges they paid?

My son recently had to have some lab tests, the lab saw this as a $300 charge. However, the insurance negotiated charge was $65.

Ok, so someone explain to me why someone who could not afford insurance would have to pay almost 5 times as much for the same thing?

Medical costs ARE ridicuous.

My son has been having some stomach problems, the gastroenteroligist put him on meds which helped. Well, then he said take him off the meds and see what happens, if he is OK, don't come back, if he is not, make another appointment. So...tomorrow we are going back to pay for an appointment for the doctor to say put him back on the meds, which I could have figured out on my own. And since he is a specialist, my insurance will be paying about $230, and I will be paying $20. I wish I could get paid that much for an obvious thought.

 

[delilah]

Well, speaking as a doctor, if I charge $50 for an office visit, only 63% is collectible, on average, either from patient or insurance company. Then I have to pay my office staff and overhead, like office space, cleaning people, bandaid, which is another 60-70%. I am lucky if I get $8 of that $50 bill.

 

[Lisa loves Pooh]

My son recently had to have some lab tests, the lab saw this as a $300 charge. However, the insurance negotiated charge was $65..

My PT office had a different price for cash patients. He billed me the medicare price. Medicare doesn't allow those big expensive charges.

They bill the insurance company for more so that they can get what they can get.

If they billed only the "real" cost---they would only get a fraction of that and be doing their work for pennies and not be able to pay THEIR bills.

(this is a PT office only--I cannot speak for doctors offices or hospitals as I did not go and interview them. I was in a situation where I had used all my PT visits and this was for a post-surgery PT. So I was able to do it as uninsured. Had I tried to bill the insurance company--I would have been responsible for the FULL amount. So no insurance company--cheaper rate.)

 

[torinsmom]

I know medical care is expensive, but sometimes it can be unreasonable and unpredictable! Part is because of how the facilitities/insurance work(or don't work) together.

Example: I had brain surgery 3 years ago(inpatient and my part of the $40,000 bill was less that $2000 ). I go for follow-up care to the Neurosurgeon. For five minutes of him looking in my eyes and asking me a few questions, writing a refill for a script, I was charged a $50 copay and then got a bill in the mail for $210. This is all($260) for an office visit with no procedures. Because his office is in a hospital, even an office visit is considered outpatient care, and I know most of this goes to the hospital. BTW, I have Blue Cross Blue Shield. So, I have since transferred to a freestanding neurologist when I need care.

I went to an gastroenterologist last year at his office NOT in a hospital. Had to pay the $50 copay, insurance paid the rest. Went back for for a procedure(can't remember the name) and paid the $50 copay and paid NOTHING for the procedure.

I have also had 2 outpatient MRI's, one place was affiliated with a hospital, one was freestanding. The hospital one cost me $1000, the freestanding one cost me $0!

So......it is very important that you check with your insurance about what is covered BEFORE you seek care. BCBS has been very good about helping me with finding the least expensive option.

BTW, if you ever look at an actual hospital bill, you would be amazed at the huge price they charge for ibuprofen and things like that. I know the drs' deserve lots of $ for all their skill, but how can they charge 10x the value of something like medicine?

Marsha

 

[OhMari]

Well, speaking as a doctor, if I charge $50 for an office visit, only 63% is collectible, on average, either from patient or insurance company. Then I have to pay my office staff and overhead, like office space, cleaning people, bandaid, which is another 60-70%. I am lucky if I get $8 of that $50 bill.

I totally understand your overhead costs. It is good to see yourside. But how many patients do you see in an hour. If you see 4, that is still $32 an hour. If you see 2 patients you are making $16 an hour, and that is probably what the majority of your average patient makes an hour. Personnally I make less than that and my husband makes slightly more.

 

[PhotobearSam]

For the person who asked how long I waited for surgery, the doctor almost took me the first day I saw him in the emergency room but he had an emergency surgery to attend to and the time ran late. So he wanted me 2 weeks later but I could not as we own apartment buildings and that was the 1st of April...so he did it on April 12th...I was cure in less than a month.

I know that we can't always get super fast treatment for non-life threatening things and the waits for things like MRI's are sometimes long...but My DAD has had 4 heart surgeries and had very good doctors (he has "kinks in his ateries and they clog in the kinks because they are narrow) and we have never gotten a bill...That makes it worth it.

I know that we are not perfect, I get that...but we won't loose our house because someone gets sick, we won't go into debt if someone breaks an arm and the POOR get seen when in some countries, only the well-off can see a doctor.


I know that for somethings, Canadians with money have gone to the states to Skip the line...That is their choice...but for the most part, we have it pretty good.

That is all I am saying.

 

[Horseshoes]

To the OP--

I agree the charges are ridiculous. We pay a hefty sum every month for health insurance benefits.


My mom went to the ENT for a hearing check. The MD looked in her ears and said "ohh you have a little wax," he took a little tool and stuck it in her ear. And that was it--maybe 30 seconds, if that.

They charged her insurance for SURGERY!!!!!!!!!!!!!

She called the office to ask what "surgery" did she have there, and they said it was the wax removal and thats how they have to bill the insurance.

 

[toto2]

For the person who asked how long I waited for surgery, the doctor almost took me the first day I saw him in the emergency room but he had an emergency surgery to attend to and the time ran late. So he wanted me 2 weeks later but I could not as we own apartment buildings and that was the 1st of April...so he did it on April 12th...I was cure in less than a month.

I know that we can't always get super fast treatment for non-life threatening things and the waits for things like MRI's are sometimes long...but My DAD has had 4 heart surgeries and had very good doctors (he has "kinks in his ateries and they clog in the kinks because they are narrow) and we have never gotten a bill...That makes it worth it.

I know that we are not perfect, I get that...but we won't loose our house because someone gets sick, we won't go into debt if someone breaks an arm and the POOR get seen when in some countries, only the well-off can see a doctor.


I know that for somethings, Canadians with money have gone to the states to Skip the line...That is their choice...but for the most part, we have it pretty good.

That is all I am saying.

You took the word out of my mouth !

My mother in law went to the emergency last fall for her heart. with in 3 day , she was send , by ambulance to Montréal ( from a city 60klm away) to have a pacemaker , and brought back , all for "free"(we do pay a lot of taxes)


Three weeks later , back to the emergency , they realise that one of her atery is almost blocked: back to Montréal , within two days to have the vein unclogged with alittle balloon and back to her home town...all for free.

Is everything perfect ? Of course not. it is not anywhere: but at least , the basic human right of health is not for profit !

 

[luvdzne]

You are very lucky that your dd did not break her wrist. Our son fell off his bike and ended up breaking his wrist. The doctor told us we have one chance to get it fixed right or he will always have problems with his hand. I don't care what it costs us as long as it gets fixed.

Sometimes you just need to count your blessings.

We were very thankful she didn't break it. I am thinking it is only a matter of time before she actually does. She has fallen off her bike 2 more times since then, luckily just cutting up her hand, and pride.

 

[froglady]

I totally understand your overhead costs. It is good to see yourside. But how many patients do you see in an hour. If you see 4, that is still $32 an hour. If you see 2 patients you are making $16 an hour, and that is probably what the majority of your average patient makes an hour. Personnally I make less than that and my husband makes slightly more.

When the average patient goes through and pays for 4 years of college, 4 years of medical school, at LEAST 2 years of residency; some specialists require 6 years of residency and a fellowship, with 24 hour night call, expensive malpractice payments and other overhead, and constant continuing education to maintain his/her license, THEN the doctor should feel guilty about charging so much.

When DH is on call, he sees patients in the ER. BEFORE he ever sees that child, he's spoken on the phone with 1. the outlying ER doctor 2. the "downtown" ER to give them a heads-up (depending upon the injury) 3. cast tech or assistant

When he arrives at the ER, he will look at any x-rays. If they're from another facility, he'll order more, as the quality usually isn't good enough. The H&P is usually done by a resident, so he reviews it, and makes a treatment plan. If surgery is needed, he has to contact the OR, and also speak with the Anaethesiologist. He also has to review the x-rays with the radiologist.

THEN, he'll finally see the actual patient, talk to the family, and arrange for treatment. This may take 2 minutes, or 15-20, depending upon the circumstances. He may have to look up information about the condition if it's uncommon. He may have to consult with another doctor, depending upon H&P. (ie, any other conditions that might affect treatment)

All this after being woken from a sound sleep, or taken away from dinner, or just leaving home an hour after arriving. If the OR is involved, he won't be home again for hours.

So, as far as the patient/family is concerned, they were charged an outrageous fee for a 2 minute, "slap a cast/splint on it" or "we're going to have to operate" visit by the doctor.

You're not paying for the time; you're paying for the knowledge. As an electrician (after taking 5 minutes to fix a problem, and charging me $100) told me, "You're not paying for my time, you're paying for my experience. You COULD have fixed it yourself, IF you had known what was wrong, what needed to be done, and had the right tools/equipment."

 

[Galahad]

I totally understand your overhead costs. It is good to see yourside. But how many patients do you see in an hour. If you see 4, that is still $32 an hour. If you see 2 patients you are making $16 an hour, and that is probably what the majority of your average patient makes an hour. Personnally I make less than that and my husband makes slightly more.

Nobody's going to stay in medicine for $32/hour.

 

[jgmklmhem]

Nobody's going to stay in medicine for $32/hour.

Especially when this scenario still hasn't even taken out the malpractice insurance.

 

[LoraJ]

Nobody's going to stay in medicine for $32/hour.

Is that because doctors are in it only for the money and not because they actually want to HELP people?

I can't tell you how disgusted I have become with doctors and nurses and their staff the last couple of months since my boyfriend's dad has been in and out of the hospital with cancer. Especially the doctors. They only seem to be in it for the money. They only go through the motions, never follow through with anything in getting him the care he needs. It's outrageous. He was supposed to have surgery to remove the tumor and still hasn't heard anything and no one returns the calls we make to them.

When he was in the hospital, his surgeon went out of town for a week, and the guy who replaced him didn't bother at all to check into his case, would come to his room, ask how he was feeling and then leave. He sent him a bill for $150 for each visit. Disgusting!

I know that there are many caring doctors and nurses out there. But not this hospital that he was at. They put him in a room, the second time he was there, and he needed tissues and straws. I asked the nurses for some and I got nothing but attitude and eye rolls. He needs pain meds and it takes them 45 minutes to an hour to give it to him even though he was due for a new dose 2 hours earlier.

One doctor seemed like he cared. He got some things in motion. But then his dad was getting sick off of the meds he perscribed so bf called him a few times and left messages. This was 3 weeks ago and we never heard back from him.

 

[Galahad]

Is that because doctors are in it only for the money and not because they actually want to HELP people?

So if someone won't prepare for and do what is arguable the hardest "regular" job there is for some determined smaller abount of money they are only "in it for the money"? They should just want the HELP people (and face complete ruin every day for just trying to help them) and have no concern over a return on their investment in preparation and expertise? 23% of the care my wife gives is completely charity for which she recieves nothing. Should that be more?